2016 ADAMS MARCHING BAND CAMP Late Arrival, Early Departure, Temporary Leave and Return Authorization Form Date: ______________

Student’s Full Name:

___________________________________________

Address:

___________________________________________

___________________________________________

Student’s Home Phone: _____________________________

Student’s Cell Phone: _____________________________

I give my permission for ________________________________________ to arrive to / depart from Colombiere Center: Student Name

2016 Late Arrival, Early Departure OR Temporary Leave and Return Schedule Sun July 24 Leave Arrive

Mon July 25 Leave Arrive

Tues July 26 Leave Arrive

Wed July 27 Leave Arrive

Thurs July 28 Leave Arrive

Fri July 29 Leave Arrive

Please list specific times for arrivals and departures. My student will arrive / depart Colombiere Center with the following authorized person:

______________________________________/_______________________ or Authorized Person Relationship

check here if student is driving.

I hereby give my permission to release my student to the above authorized person or allow my student to drive.

_____________________________________________________/____________________________/_______________. Signature of Guardian Guardian Cell Phone Date

Band Director approval: _______________________________________________________/____________________. Mr. Ferden’s signature Date *Note: Michigan law states that when a student leaves or arrives at camp they must be signed in & out. When checking a student in or out, please see the Parent Band Camp Chaperone. Return signed form to: Band Camp Coordinator Laurie Morris 248-601-2855 [email protected] revised 7/8/16

Director of Bands James Ferden 248-726-5375 [email protected]